Estabilidade primária do implante dental

Primary stability derives mainly from mechanical involvement with the cortical bone and the lack of mobility in the bone bed at the insertion of the implant and depends on the quantity and quality of the bone, the surgical technique, and the design of the implant. The titles were captured in the database PubMed, Scielo, and relevant Brazilian magazines to identify the primary stability, after the insertion of the implant in the region indicated in the protocol. Tapered implants showed greater primary stability compared to cylindrical implants, when placed under bone density conditions. The geometry of the implant is an important factor in the degree of primary stability. Based on this, large threads are desirable in cases of poor bone quality. The insertion torque values are very important for the clinical determination of the levels of primary stability and the absence of micro movements whenever an immediate load is applied. The implant, used as if it were the last cutter, when correctly inserted, penetrates with pressure in the bone store if its diameter is larger than that of the cutter perforation. The implant design plays an influential role in achieving its primary stability.

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Does the manual insertion torque of smartpegs affect the outcome of implant stability quotients (ISQ) during resonance frequency analysis (RFA)?

International Journal of Implant Dentistry ◽

10.1186/s40729-019-0195-1 ◽

2019 ◽

Vol 5 (1) ◽

Cited By ~ 1

Author(s):

Ingrid Kästel ◽

Giles de Quincey ◽

Jörg Neugebauer ◽

Robert Sader ◽

Peter Gehrke

Keyword(s):

Resonance Frequency ◽

Frequency Analysis ◽

Insertion Torque ◽

Resonance Frequency Analysis ◽

Implant Stability ◽

Reliable Determination ◽

Torque Values ◽

Finger Pressure

Abstract Background There is disagreement about the optimal torque for tightening smartpegs for resonance frequency analysis (RFA). Subjective finger pressure during hand tightening could affect the reliability of the resulting values. The aim of the current study was therefore to assess whether or not the insertion torque of a smartpeg magnetic device influences the implant stability quotient (ISQ) value during RFA. Methods Thirty self-tapping screw implants (XiVE S, Dentsply Sirona Implants, Bensheim, Germany) with a diameter of 3.8 mm and a length of 11 mm were inserted in three cow ribs with a bone quality of D1. The RFA value of each implant was measured (Ostell, FA W&H Dentalwerk, Bürmoos, Austria) in two orthogonal directions (mesial and buccal) after tightening the corresponding smartpeg type 45 with a mechanically defined value of 5 Ncm (Meg Torq device, Megagen, Daegu, South Korea) (test). Additionally, 4 different examiners measured the RFA after hand tightening the smartpegs, and the results were compared (control). Insertion torque values were determined by measuring the unscrew torque of hand seated smartpegs (Tohnichi Manufacturing Co. Ltd, Tokyo, Japan). Results The ISQ values varied from 2 to 11 Ncm by hand tightening and from 2 to 6 Ncm by machine tightening. The comparison of hand and machine tightening of smartpegs displayed only minor differences in the mean ISQ values with low standard deviations (mesial 79.76 ± 2,11, buccal 77.98 ± 2,) and no statistical difference (mesial p = 0,343 and buccal p = 0,890). Conclusions Manual tightening of smartpeg transducers allows for an objective and reliable determination of ISQ values during RFA.

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Why Guided When Freehand Is Easier, Quicker, and Less Costly?

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-14-00231 ◽

2014 ◽

Vol 40 (6) ◽

pp. 670-678 ◽

Cited By ~ 9

Author(s):

Paul A. Schnitman ◽

Chie Hayashi ◽

Rita K. Han

Keyword(s):

Bone Density ◽

Resonance Frequency ◽

Primary Stability ◽

Patient Comfort ◽

Implant Design ◽

Computer Assisted ◽

Insertion Torque ◽

Treatment Indications ◽

Bone Level ◽

Observation Period

Computer-assisted implant planning and subsequent production of a surgical template based on this plan has gained attention because it provides restoratively driven esthetics, patient comfort, satisfaction, and the option of flapless surgery and immediate restoration. However, it adds expense and requires more time. Another significant but not so apparent advantage may be improved survival and success over freehand techniques in types III and IV bone. This retrospective analysis was undertaken to examine that possibility. It reports 1-year outcome for 80 implants in 27 consecutively presenting patients treated over a 7-year period using computer-assisted techniques across all bone qualities in commonly encountered treatment indications in private practice. Implants were placed to support single teeth, small bridges, and complete arch restorations in exposed or immediately restored applications, based on primary stability as determined by insertion torque, resonance frequency analysis, and Periotest. For the 80 implants supporting 35 restorations, the median observation period is 2.66 years; 73 implants supporting prostheses in 22 patients had readable radiographs at 1 year. There was a 1-year overall implant survival and a success rate of 100%. Radiographic analysis demonstrated the change in bone level from the platform at 1-year is less than 2 mm. Intra-operative median measurements of primary stability were insertion torque, 40 Ncm; resonance frequency, 76 ISQ; and Periotest, −3. All intra-operative measurements were consistent for acceptable primary stability regardless of bone density. Restoratively driven diagnosis and precision planning and initial fit were possible with computer-assisted techniques resulting in the achievement of high primary stability, even in areas of less dense bone. The ability to plan implant position, drill sequence, and implant design on the basis of predetermined bone density gives the practitioner enhanced pretreatment information which can lead to improved outcome.

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Socket preservation using xenograft does not impair implant primary stability in sheep: clinical, histological and histomorphometric study

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-19-00237 ◽

2020 ◽

Author(s):

Yaniv Mayer ◽

Ofir Ginesin ◽

Hadar Zigdon-Giladi

Keyword(s):

Bone Biopsy ◽

Primary Stability ◽

Insertion Torque ◽

Socket Preservation ◽

Histomorphometric Study ◽

Implant Placement ◽

High Bone ◽

Delayed Implant Placement ◽

Natural Healing

Implant primary stability, which depends mainly on the amount and quality of bone, is important for implant survival. Socket preservation aims to reduce bone volumetric changes following tooth extraction. This animal study aims to examine whether preserving a ridge by using xenograft impairs the primary stability of the implant. Eighteen artificial bone defects were prepared in four sheep (5mmØ and 8mm length). Defects were randomly grafted with xenografts: Bio-Oss (BO), Bioactive Bone (BB), or left for natural healing (control). After 8 weeks, bone biopsy was harvested and dental implants installed. During installation, peak insertion torque (IT) was measured by hand ratchet, and primary stability by the Osstell method. Histomorphometric analysis showed a higher percentage of new bone formation in the naturally healed defects compared to sites with xenograft (control 68.66 ± 4.5%, BB 48.75 ± 4.34%, BO 50.33 ± 4.0%). Connective tissue portion was higher in the BO and BB groups compared to control (44.25 ± 2.98%, 41 ± 6%, and 31.33 ± 4.5, p<0.05, respectively). Residual grafting material was similar in BO and BB (7 ± 2.44%, 8.66 ± 2.1 %, respectively). Mean IT and ISQ values were not statistically different among the groups. A positive correlation was found between IT and ISQ (r=0.65, p=0.00). In conclusion, previously grafted defects with xenograft did not influence primary stability and implant insertion torque in delayed implant placement. These results may be attributed to a relatively high bone fill of the defect (~50%) two months after grafting.

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Comparative In Vitro Evaluation of the Primary Stability in D3 Synthetic Bone of Two Different Shapes and Pitches of the Implant Threads

Applied Sciences ◽

10.3390/app11125612 ◽

2021 ◽

Vol 11 (12) ◽

pp. 5612

Author(s):

Stefano Fanali ◽

Margherita Tumedei ◽

Pamela Pignatelli ◽

Alessandra Lucchese ◽

Francesco Inchingolo ◽

...

Keyword(s):

Surgical Techniques ◽

Primary Stability ◽

Implant Design ◽

Insertion Torque ◽

Synthetic Bone ◽

One Stage ◽

Prosthetic Joint ◽

Joint Connection ◽

The One

Background: Implant primary stability can be affected by several factors related to implant macrogeometry, local anatomy, and surgical techniques. The aim of this research was to study primary stability on polyurethane foam sheets of wide-threaded implant design compared to narrow-threaded implants. Materials and methods: Two different implant designs were positioned on D3 density polyurethane blocks in a standardized environment: the wide-threaded implant and the narrow-threaded implant, for a total of 160 specimens. Moreover, for each group, two different sizes were considered: 3.8mm × 12mm and 4.8mm × 12 mm. The insertion torque (IT) values, the removal strength (RT), and the Periotest analyses were evaluated. Results: A significantly higher IT and RT was reported for wide-threaded implants and two-stage implants (p < 0.01), compared to the narrow-threaded implants. The diameters seemed to provide a significant effect on the primary stability for both implants’ geometry (p < 0.01). A higher mean of the one-stage implant was evident in the Periotest measurements (p < 0.01). Conclusions: Both of the implants showed sufficient stability in polyurethane artificial simulation, while the wide-threaded implant design showed a higher primary stability on alveolar cancellous synthetic bone in vitro. Additionally, the prosthetic joint connection seemed to have a determinant effect on Periotest analysis, and the one-stage implants seemed to provide a high stability of the fixture when positioned in the osteotomy, which could be important for the immediate loading protocol.

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How Do Parameters of Implant Primary Stability Correspond with CT-Evaluated Bone Quality in the Posterior Maxilla? A Correlation Analysis

Materials ◽

10.3390/ma14020270 ◽

2021 ◽

Vol 14 (2) ◽

pp. 270

Author(s):

Ji-Hyun Kim ◽

Young-Jun Lim ◽

Bongju Kim ◽

Jungwon Lee

Keyword(s):

Bone Density ◽

Bone Quality ◽

Objective Assessment ◽

Primary Stability ◽

Insertion Torque ◽

Hounsfield Units ◽

Stability Parameters ◽

Posterior Maxilla ◽

Different Types ◽

Edentulous Patients

The aim of the present study was to evaluate correlations between bone density and implant primary stability, considering various determinants such as age, gender, and geometry of implants (design, diameter). Bone density of edentulous posterior maxillae was assessed by computed tomography (CT)-derived Hounsfield units, and implant primary stability values were measured with insertion torque and resonance frequency analysis (RFA). A total of 60 implants in 30 partially edentulous patients were evaluated in the posterior maxilla with two different types of dental implants. The bone density evaluated by CT-derived Hounsfield units showed a significant correlation with primary stability parameters. The bone quality was more influenced by gender rather than age, and the type of implant was insignificant when determining primary stability. Such results imply that primary stability parameters can be used for objective assessment of bone quality, allowing surgical modifications especially in sites suspected of poor bone quality.

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New Implant Design with Midcrestal and Apical Wing Thread for Increased Implant Stability in Single Postextraction Maxillary Implant

Case Reports in Dentistry ◽

10.1155/2019/9529248 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Antonio Scarano ◽

Bartolomeo Assenza ◽

Francesco Inchingolo ◽

Filiberto Mastrangelo ◽

Felice Lorusso

Keyword(s):

Cortical Bone ◽

Dental Implant ◽

Alveolar Bone ◽

Primary Stability ◽

Implant Design ◽

Insertion Torque ◽

Fixture Design ◽

Implant Stability ◽

Implant Placement ◽

Immediate Placement

Background. The immediate placement of a dental implant could represent an option treatment for the rehabilitation of a postextractive missing tooth socket to replace compromised or untreatable teeth, with the advantage of single-session surgery. In this way, the anatomy of the alveolar bone defect, the preservation of the buccal cortical bone, and the primary stability of the fixture represent the critical factors that consent a precise implant placement. Objective. This case report describes a novel fixture design for postextractive alveolar socket immediate implant. Methods. Two patients (25 and 31 years old) were treated for postextractive dental implant placement to replace both central upper incisor teeth with four implants. The residual bone implant gap was not filled with graft or bone substitute. The restoration was provided following a standard loading protocol by a cement-sealed prosthetic abutment. Results. Clinically, all implants positioned showed an excellent insertion torque. No postoperative complications were reported. At 6 months of healing, the buccal cortical bone and the implant stability were present and well maintained. Conclusion. The evidence of this study allows us to underline the possible advantages of this new fixture design for postextractive implant technique.

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Primary Stability Optimization by Using Fixtures with Different Thread Depth According To Bone Density: A Clinical Prospective Study on Early Loaded Implants

Materials ◽

10.3390/ma12152398 ◽

2019 ◽

Vol 12 (15) ◽

pp. 2398 ◽

Cited By ~ 8

Author(s):

Christian Makary ◽

Abdallah Menhall ◽

Carole Zammarie ◽

Teresa Lombardi ◽

Seung Yeup Lee ◽

...

Keyword(s):

Bone Density ◽

Primary Stability ◽

Stability Loss ◽

Insertion Torque ◽

Implant Stability ◽

Marginal Bone Loss ◽

Early Loading ◽

Bone Level ◽

Implant Therapy ◽

Provisional Restoration

Background: Macro- and micro-geometry are among the factors influencing implant stability and potentially determining loading protocol. The purpose of this study was to test a protocol for early loading by controlling implant stability with the selection of fixtures with different thread depth according to the bone density of the implant site. Materials and Methods: Patients needing implant therapy for fixed prosthetic rehabilitation were treated by inserting fixtures with four different thread diameters, selected based on clinical assessment of bone quality at placement (D1, D2, D3, and D4, according to Misch classification). Final insertion torque (IT) and implant stability quotient (ISQ) were recorded at baseline and ISQ measurements repeated after one, two, three, and four weeks. At the three-week measurement (four weeks after implant replacement), implants with ISQ > 70 Ncm were functionally loaded with provisional restorations. Marginal bone level was radiographically measured 12 months after implant insertion. Results: Fourteen patients were treated with the insertion of forty implants: Among them, 39 implants showing ISQ > 70 after 3 weeks of healing were loaded with provisional restoration. Mean IT value was 82.3 ± 33.2 Ncm and varied between the four different types of bone (107.2 ± 35.6 Ncm, 74.7 ± 14.0 Ncm, 76.5 ± 31.1 Ncm, and 55.2 ± 22.6 Ncm in D1, D2, D3, and D4 bone, respectively). Results showed significant differences except between D2 and D3 bone types. Mean ISQ at baseline was 79.3 ± 4.3 and values in D1, D2, D3, and D4 bone were 81.9 ± 2.0, 81.1 ± 1.0, 78.3 ± 3.7, and 73.2 ± 4.9, respectively. Results showed significant differences except between D1 and D2 bone types. IT and ISQ showed a significant positive correlation when analyzing the entire sample (p = 0.0002) and D4 bone type (p = 0.0008). The correlation between IT and ISQ was not significant when considering D1, D2, and D3 types (p = 0.28; p = 0.31; p = 0.16, respectively). ISQ values showed a slight drop at three weeks for D1, D2, and D3 bone while remaining almost unchanged in D4 bone. At 12-month follow-up, all implants (39 early loading, 1 conventional loading) had satisfactory function, showing an average marginal bone loss of 0.12 ± 0.12 mm, when compared to baseline levels. Conclusion: Matching implant macro-geometry to bone density can lead to adequate implant stability both in hard and soft bone. High primary stability and limited implant stability loss during the first month of healing could allow the application of early loading protocols with predictable clinical outcomes.

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Effects of Intrabony Length and Cortical Bone Density on the Primary Stability of Orthodontic Miniscrews

Materials ◽

10.3390/ma13245615 ◽

2020 ◽

Vol 13 (24) ◽

pp. 5615

Author(s):

Jie Jin ◽

Gi-Tae Kim ◽

Jae-Sung Kwon ◽

Sung-Hwan Choi

Keyword(s):

Bone Density ◽

Cortical Bone ◽

Primary Stability ◽

Insertion Torque ◽

Low Density ◽

Horizontal Resistance ◽

Cortical Bone Density ◽

Temporary Anchorage Devices ◽

Implantation Depth ◽

Maximum Removal

Miniscrews have gained recent popularity as temporary anchorage devices in orthodontic treatments, where failure due to sinus perforations or damage to the neighboring roots have increased. Issues regarding miniscrews in insufficient interradicular space must also be resolved. This study aimed to evaluate the primary stability of miniscrews shorter than 6 mm and their feasibility in artificial bone with densities of 30, 40, and 50 pounds per cubic foot (pcf). The primary stability was evaluated by adjusting the intrabony miniscrew length, based on several physical properties: maximum insertion torque (MIT), maximum removal torque (MRT), removal angular momentum (RAM), horizontal resistance, and micromotion. The MIT and micromotion results demonstrated that the intrabony length of a miniscrew significantly affected its stability in low-density cortical bone, unlike cases with a higher cortical bone density (p < 0.05). The horizontal resistance, MRT, and RAM were affected by the intrabony length, regardless of the bone density (p < 0.05). Thus, the primary stability of miniscrews was affected by both the cortical bone density and intrabony length. The effect of the intrabony length was more significant in low-density cortical bone, where the implantation depth increased as more energy was required to remove the miniscrew. This facilitated higher resistance and a lower risk of falling out.

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Mechanical stability and clinical applicability assessment of novel orthodontic mini-implant design

The Angle Orthodontist ◽

10.2319/111412-876.1 ◽

2013 ◽

Vol 83 (5) ◽

pp. 832-841 ◽

Cited By ~ 6

Author(s):

Ha Na Song ◽

Christine Hong ◽

Robert Banh ◽

Tania Ohebsion ◽

Greg Asatrian ◽

...

Keyword(s):

Cortical Bone ◽

Mechanical Stability ◽

Primary Stability ◽

Tension Force ◽

Implant Design ◽

Insertion Torque ◽

Compression Force ◽

Clinical Applicability ◽

The Mean ◽

The Stability

ABSTRACT Objective: To compare the stability and clinical applicability of a novel orthodontic mini-implant design (N2) with the most widely used commercially available (CA) design. Materials and Methods: Two groups of mini-implants were tested: a CA design (1.5-mm diameter, 6-mm length) and N2 (3-mm diameter, 2-mm length, tapered shape). Implants were inserted in bone blocks of cortical bone simulation with varying densities (20 pounds per cubic foot [pcf], 30 pcf, and 40 pcf). A torque test was used to measure maximum insertion torque (MIT) and maximum removal torque (MRT). Compression and tension force vectors were applied at angles of 10°, 20°, 30°, and 40° using customized load pins to determine primary stability. Results: Mean MIT and MRT were higher in the N2 than the CA design at all three cortical bone densities except MRT in 20 pcf bone (not statistically significant). The mean compression force required to displace the N2 at all distances and angulations was greater for the N2 than the CA design. At all displacement distances, the highest mean tension force required for N2 displacement was at 10° angulation, whereas at 30° and 40°, the mean tension force required to displace the CA design was greater. Conclusions: The primary stability of the N2 is superior to that of the CA design and is promising for both orthodontic and orthopedic clinical applicability, especially under compression force. The short length of the N2 reduces risk of damage to anatomic structures and root proximity during placement and orthodontic treatment. The stability of the N2 may be compromised in areas of high bone density and highly angulated tension force.

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Influence of Implant Thread Morphology on Primary Stability: A Prospective Clinical Study

BioMed Research International ◽

10.1155/2020/6974050 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Maria Menini ◽

Francesco Bagnasco ◽

Ivan Calimodio ◽

Nicolò Di Tullio ◽

Francesca Delucchi ◽

...

Keyword(s):

Clinical Outcomes ◽

Outcome Measures ◽

Primary Stability ◽

Secondary Outcome ◽

Prospective Clinical Study ◽

Insertion Torque ◽

Significant Difference ◽

Group 5 ◽

One Year ◽

Torque Values

Objectives. The purpose of this study was to evaluate the primary stability of two implants with the same macro- and micromorphology but different thread design and analyze their clinical outcomes over a one-year period. Materials and Methods. 14 patients needing a partial rehabilitation with a delayed loading approach (DEL group: 9 patients) or a full-arch rehabilitation treated with immediately loaded fixed prostheses supported by 4 implants following the Columbus Bridge Protocol (CBP) (IL group: 5 patients) were included. In each patient, at least one SY (implant with standard threads) and one SL implant (implant with an augmented depth of the threads) were randomly inserted. Primary outcome measures were the number of threads exposed at a torque of 30 Ncm and 50 Ncm and final insertion torque. Secondary outcome measures were implant and prosthetic failure, peri-implant bone resorption, and periodontal parameters: bleeding on probing (BoP), plaque index (PI), and probing depth (PD) evaluated at 3, 6, and 12 months of healing. Results. Nineteen SY and 19 SL implants were inserted in 14 patients. Twenty implants (10 SL and 10 SY) were inserted in the IL group, while 18 (9 SL and 9 SY) were inserted in the DEL group and followed-up for 12 months. No patients dropped out. No implants and prostheses failed. No biological complications were identified. No significant differences were found between SY and SL implants comparing the number of exposed threads when inserting the implant with a torque insertion of 30 N (T student test p=.142 and U test p=.164). At 50 N, no threads were visible in either groups. Final torque insertion values were higher for SL (mean: 48.42 Ncm) compared to SY implants (mean: 43.42 Ncm) without a statistically significant difference. All the implants showed good clinical outcomes at the 1-year-in-function visit. Conclusions. After 12 months of function, both implant types provided good clinical outcomes without statistically significant differences between the two groups. A difference in insertion torque (even if not statistically significant) was found with higher insertion torque values for SL implants with a larger thread depth.

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